Abstract
Surgical repair of neglected Achilles tendon ruptures presents the challenge of restoring the function of the Achilles tendon complex while repairing the large defect that is created by the delay in appropriate treatment. We present our preferred technique for delayed repair and the results of six patients who were available for complete follow-up evaluation. The combined surgical technique includes: V-to-Y gastrocnemius recession or advancement, excision of the fibroadipose defect, end-to-end anastomosis, gastrocnemius aponeurotic flap to reinforce the anastomosis. Each of six patients were interviewed and examined clinically and by Cybex II isokinetic strength testing. All six patients have been able to return to their pre-injury activities. Cybex II isokinetic strength testing demonstrated peak torque deficiencies in plantar flexion ranging from 2.5%–22% as compared with the unaffected limb. The overall results of the technique described indicate that very satisfactory functioning of a neglected Achilles tendon rupture can be obtained.
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Abraham E, Pankovich AM (1975) Neglected ruptures of Achilles tendon. J Bone Joint Surg [Am] 57:253–255
Amer O, Lindholm A (1959) Subcutaneous rupture of the Achilles tendon: a study of 92 cases. Acta Chir Scand (Suppl) 239
Bosworth DM (1956) Repair of defects in the tendo Achillis. J Bone Joint Surg [Am] 38:111–114
Hattrup SJ, Johnson KA (1986) A review of ruptures of the Achilles tendon. Foot Ankle 6:34–38
Howard CB, Winston I, Bell W, Mackie I, Jenkius DHR (1984) Late repair of the calcaneal tendon with carbon fiber. J Bone Joint Surg [Br] 66:206–209
Ingliss AE, Scott N, Sculco JP, Patterson AE (1976) Ruptures of the tendo Achillis: an objective assessment of surgical and non-surgical treatment. J Bone Joint Surg [Am] 58:990–993
Ketchum LD (1977) Primary tendon healing: a review. J Hand Surg 2:428–535
Kissel CG, Blacklidge DK, Crowley DL (1994) Repair of neglected achilles tendon rupture-procedure and functional results. J Foot Ankle Surg 33:46–52
Kleinert HE, Smith DJ (1982) Primary and secondary repairs of flexor and extensor tendon injuries. In: Flynn JE (ed) Hand surgery. Williams & Wilkins, Baltimore, pp 220–242
Lynn T (1966) Repair of the torn Achilles tendon using plantaris tendon as a reinforcing membrane. J Bone Joint Surg [Am] 48:268–272
Quigley JB, Schollar AD (1980) Surgical repair of the ruptured Achilles tendon. Am J Sports Med 8:244–250
Wills CA, Washburn S, Caiozzo V, Prietto CA (1986) Achilles tendon rupture: a review of the literature comparing surgical versus non-surgical treatment. Clin Orthop 207:156–163
Zadek I (1940) Repair of old rupture of the tendon Achillis by means of fascia lata. J Bone Joint Surg 22:1070–1071
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Us, A.K., Bilgin, S.S., Aydin, T. et al. Repair of neglected Achilles tendon ruptures: procedures and functional results. Arch Orthop Trauma Surg 116, 408–411 (1997). https://doi.org/10.1007/BF00434001
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DOI: https://doi.org/10.1007/BF00434001